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Frequent use of digital media may be associated with the development of symptoms of attention deficit disorder (ADHD or ADD) in teens, according to a new study published in the Journal of American Medical Association.1 The association between screen time and ADHD is modest at best, but the study does highlight the need for further research on adolescents’ media use.

In this prospective, longitudinal study, researchers analyzed data from 2,587 adolescents between the ages of 15 and 16 (54% girls) from 10 high schools in Los Angeles County, California, from September 2014 to December 2016. At baseline, none of the students was classified as having ADHD symptoms based on the Current Symptoms Self-Report Form score. Data analyzed included surveys completed at baseline and at 6, 12, 18, and 24 months. At each point, adolescents who reported 6 or more symptoms in either the inattention or hyperactivity-impulsivity categories were classified as having ADHD symptoms over the past 6 months.

The results analyzed included 14 different high-frequency (defined as many time per day) digital media activities; these included checking social media sites, liking or commenting on others’ posts, online browsing, streaming videos, or playing games. The distribution of 14 high-frequency digital media activities had a mean of 3.62. The most common high-frequency activity reported was checking social media sites (54.1%). Across follow-ups, the students who reported zero high-frequency media use at baseline had a lower rate of having ADHD symptoms (n=495, 4.6%) than did students who had reported 7 high-frequency activities (n=114, 9.5%) and students who reported 14 high-frequency activities (n=51, 10.5%).

Though high-frequency media use was associated with only a 10% increased risk of later developing or displaying ADHD symptoms overall, boys and adolescents with more depressive symptoms and delinquent behaviors (such as stealing and skipping school) were more likely to exhibit ADHD symptoms during follow-up.

The authors of the study note that the change in ADHD symptoms associated with each incremental increase in media exposure was modest and that unmeasured confounders could account for some of this association. In fact, the survey respondents who reported checking social media sites (54.1%) and browsing or viewing images daily (42.9%) is consistent with the numbers reported in a recent Pew internet survey of American adolescents, as noted by Jenny Radesky, M.D., from the University of Michigan School of Medicine, Ann Arbor, in an accompanying editorial.2

The study results, however tenuous their connection to ADHD, highlight the importance of parental involvement in adolescents’ media use and “affirm the 2016 American Academy of Pediatrics guidelines to prioritize activities that promote adolescent executive functioning and well-being, including sleep, physical activity, distraction-free homework, and positive interactions with family and friends,” concluded Dr. Radesky.

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“Though the association between screen time and ADHD is modest, the study does highlight the need for parent involvement in adolescents’ media use.” Actually the study doesn’t highlight this at all.

The study reports an association. In research terms “association” is the weakest of links. There’s no causation. There’s not even a correlation!

Not only that, but the subjects self-reported their symptoms – a research approach known to result in confirmation bias. If you tell someone to monitor themselves for particular behaviours, they are more likely to see them, even if not there.

And the subjects are teenagers – a group known to bow to peer pressure. So many could be reporting an increase in symptoms they don’t experience because they think it’s what the researchers want to hear.

But instead of rubbishing the hysteria elsewhere in the media over this study, Sweta Cupta has repeated it. And I’m embarrassed on behalf of the rest of ADDitude’s contributors.

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